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Infective Endocarditis with a Left Ventricular Pseudoaneurysm Caused by Proteus mirabilis: A Case Report

Tadanori Minagawa1, Takahiro Ohara2, Tomoya Oizumi3

  • 1Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan.

Journal of Cardiology Cases
|January 26, 2022
PubMed

Insights

Proteus mirabilis, a common cause of urinary tract infections, can rarely lead to infective endocarditis and left ventricular pseudoaneurysms. This case highlights the need for clinical awareness of this rare but serious complication.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Proteus mirabilis is a Gram-negative bacterium primarily associated with urinary tract infections.
  • Infective endocarditis (IE) caused by P. mirabilis is exceptionally rare.
  • Left ventricular pseudoaneurysms (LVPs) are uncommon complications of infective endocarditis.

Observation:

  • An 83-year-old woman presented with urinary tract infection and P. mirabilis bacteremia.
  • Diagnostic imaging revealed mitral regurgitation and a mass on the mitral annulus, indicative of IE.
  • The patient developed a left ventricular pseudoaneurysm secondary to the infective endocarditis.

Findings:

  • P. mirabilis bacteremia can lead to infective endocarditis.
  • Infective endocarditis caused by P. mirabilis can result in the formation of left ventricular pseudoaneurysms.
  • Surgical intervention, including mitral valve replacement and patch plasty, was performed.

Implications:

  • Clinicians should consider P. mirabilis as a potential causative agent for infective endocarditis, even in the absence of typical risk factors.
  • Early recognition and management of P. mirabilis IE are crucial to prevent severe complications like LVPs.
  • This case expands the known spectrum of P. mirabilis-associated cardiovascular infections.
Keywords:
Bloodstream infectionsEndocarditisLeft ventricular pseudoaneurysmProteus mirabilisUrinary tract infections

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